Phages for Global Health

We are combating the global antibiotic resistance crisis, which is expected to kill 10 million people annually by 2050 -- far more than the roughly 2 million people who died from coronavirus during the first year of this pandemic. Since the WHO reports that none of the drugs now in clinical development will adequately treat antibiotic-resistant infections, we are facilitating the use of non-traditional drugs called bacteriophages (AKA phages) that can successfully kill antibiotic-resistant bacteria. Importantly, we are collaborating with scientists in Africa and Asia, where almost 90% of the deaths from antibiotic resistance are expected to occur. With support through the Elevate Prize, we would scale this work by:

- Teaching more African and Asian researchers how to use phages in their countries (we have helped train >1300 scientists)

- Supporting those researchers to secure more funds for their local phage product development (they have raised >$950,000)

- Working with national drug authorities to clarify how non-traditional phages might be regulated within their countries (in cooperation with US and European drug agencies)

By enabling us to scale and improve these ongoing activities, the Elevate Prize could help us transform how antibiotic-resistant infections are treated in the developing world.

I spent 15 years in the pharmaceutical industry developing drugs primarily intended for patients in industrialized countries. In parallel, I also consulted in developing countries whenever possible. The juxtaposition of working in those two worlds was disconcerting: I was making drugs in the US that typically cost $1 billion to develop, yet most people whom I met in the developing world would never be able to access those drugs. So I spent many years looking for ways I might apply my skills to address diseases in developing countries. At one point I helped teach a short-term scientific workshop in the country of Georgia, where phages have been a standard component of medical practice for nearly 100 years, including as over-the-counter drugs. Several of the participants in that workshop were from the Eliava Institute, the most famous phage research center in the world. I remember the moment one of those Georgian colleagues talked about her phage research, and I instantly realized this was the type of drug technology I had been looking for -- one that was both effective and affordable. It took another 6-12 months for the ideas to fully germinate, then I founded Phages for Global Health.

Driven by misuse of antibiotics in livestock, crops and people worldwide, antibiotic resistance is expected to cause 10 million deaths each year by 2050, almost 90% of those in Africa and Asia. Unfortunately, inappropriate use of antibiotics in COVID-19 patients is expected to accelerate antibiotic resistance rates further. 

Before antibiotics were discovered, phages were used as antibacterial agents. Phages are viruses that exist in the environment and our bodies that can kill antibiotic-resistant bacteria. Phage-based drugs are now regaining popularity in industrialized countries, and the US National Institutes of Health, the WHO, and the Gates Foundation have regarded phages as a key technology to combat the antibiotic resistance crisis. However, no phage products are available in developing countries, and few scientists there know anything about them.

Phages for Global Health is bridging this gap through 3 broad approaches: 

1. Teaching scientists how to develop phage products (through hands-on laboratory workshops in Africa and Asia)

2. Creating international teams of global phage experts and developing world scientists to co-develop phage products (e.g., for poultry meat decontamination, cholera prevention, tuberculosis treatment, etc)

3. Interacting with drug regulatory authorities in both developing and developed countries to clarify and harmonize national frameworks for regulating phage products

Most efforts to address antibiotic resistance focus on prolonging the effectiveness of existing antibiotics or financially motivating new drug innovation through the traditional drug development process. The former approach -- ensuring that antibiotics are only used when medically appropriate -- will just delay the inevitable: all conventional antibiotics will eventually become ineffective. And the second approach -- incentivizing pharmaceutical companies to make drugs for “third world” diseases -- is considered futile by many global health leaders because of the expense (each drug usually costs $1 billion to develop, yet developing world populations cannot pay standard market prices). We believe that phage-based drugs can provide a solution since they could be (1) developed cheaper and faster than conventional drugs, (2) designed to minimize future resistance, and (3) produced with relatively simple equipment that is readily available to developing world scientists. To our knowledge no other organization is specifically working to bring phage technology to developing countries. 

We are reaching two different levels of target populations: first, public health scientists in developing countries and, second, the communities they serve. Our primary goal is to provide scientists with phages as a tool to help combat the antibiotic resistance crises in their countries. By partnering with them through trainings and collaborations, we aim to empower these scientists to develop products that are both technically effective and socially accepted within their local cultures.  

In July 2017 we began delivering regional laboratory training workshops: three in East Africa, one in West Africa, and our first workshop in Southeast Asia was scheduled for November 2020 (postponed due to coronavirus). The latest surveys of the workshop participants indicate that for each scientist we have taught, they have trained at least 15 others through their home institutions -- meaning that over 1300 African scientists have been introduced to phage biology in the past few years. The workshop participants have also initiated more than 50 new phage development projects and have won grants totaling to over $950,000. Given this rapid amplification of efforts, within the next few years the products developed by these scientists could potentially save many thousands of lives, if not more.